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[Preprint]. 2021 Jan 10:2020.12.30.20248888.
doi: 10.1101/2020.12.30.20248888.

The Joint Impact of COVID-19 Vaccination and Non-Pharmaceutical Interventions on Infections, Hospitalizations, and Mortality: An Agent-Based Simulation

Mehul D Patel  1 , Erik Rosenstrom  2 , Julie S Ivy  2 , Maria E Mayorga  2 , Pinar Keskinocak  3 , Ross M Boyce  4 , Kristen Hassmiller Lich  5 , Raymond L Smith  6 , Karl T Johnson  5 , Julie L Swann  2
Affiliations

The Joint Impact of COVID-19 Vaccination and Non-Pharmaceutical Interventions on Infections, Hospitalizations, and Mortality: An Agent-Based Simulation

Mehul D Patel et al. medRxiv. .

Update in

Abstract

Background: Vaccination against SARS-CoV-2 has the potential to significantly reduce transmission and morbidity and mortality due to COVID-19. This modeling study simulated the comparative and joint impact of COVID-19 vaccine efficacy and coverage with and without non-pharmaceutical interventions (NPIs) on total infections, hospitalizations, and deaths.

Methods: An agent-based simulation model was employed to estimate incident SARS-CoV-2 infections and COVID-19-associated hospitalizations and deaths over 18 months for the State of North Carolina, a population of roughly 10.5 million. Vaccine efficacy of 50% and 90% and vaccine coverage of 25%, 50%, and 75% (at the end of a 6-month distribution period) were evaluated. Six vaccination scenarios were simulated with NPIs (i.e., reduced mobility, school closings, face mask usage) maintained and removed during the period of vaccine distribution.

Results: In the worst-case vaccination scenario (50% efficacy and 25% coverage), 2,231,134 new SARS-CoV-2 infections occurred with NPIs removed and 799,949 infections with NPIs maintained. In contrast, in the best-case scenario (90% efficacy and 75% coverage), there were 450,575 new infections with NPIs maintained and 527,409 with NPIs removed. When NPIs were removed, lower efficacy (50%) and higher coverage (75%) reduced infection risk by a greater magnitude than higher efficacy (90%) and lower coverage (25%) compared to the worst-case scenario (absolute risk reduction 13% and 8%, respectively).

Conclusion: Simulation results suggest that premature lifting of NPIs while vaccines are distributed may result in substantial increases in infections, hospitalizations, and deaths. Furthermore, as NPIs are removed, higher vaccination coverage with less efficacious vaccines can contribute to a larger reduction in risk of SARS-CoV-2 infection compared to more efficacious vaccines at lower coverage. Our findings highlight the need for well-resourced and coordinated efforts to achieve high vaccine coverage and continued adherence to NPIs before many pre-pandemic activities can be resumed.

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Conflict of interest statement

Competing Interests: The authors have no competing interests to disclose.

Figures

Fogure 1.
Fogure 1.
Agent-Based Model Framework and Structure
Figure 2.
Figure 2.
Description of Vaccination and Non-Pharmaceutical Interventions over the 18-Month Simulation
Figure 3.
Figure 3.
Daily New Infections by Vaccination and Non-Pharmaceutical Intervention Scenarios over the 18-Month Simulation
See this image and copyright information in PMC

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